possible. with this event home matters is moving beyond housing to illuminate health w is one of the health issues that starts at home. i hope you will all support this movement get on board with the matters and fill out the cards you can learn more at the american.com and facebook.com we're live twitter right now. we encourage you to do so share where home is. does home matter for health? it does. we'll tell you why home matters. awhile plotting along as a bored uninspired accountant i

volunteered for a program for the children in the foster program. one was michael a 12-year-old boy who couldn't get past his second grade mentality once removed into state custody he boinsz around from foster homes for several years and never had any stability or xhifrnt nurturing. after family identification was taken off the table i tried to find michael a home in 2004, i found a family. i went to visit michael into his new and permanent home he

recently test at the fourth grade level i was happy for him human resources as he came running towards me with more and more more energy i ever seen him. it wasn't just this new level of energy it was exciting to see this child living in a stable home was able to enjoy more but what brought the tears to my icy noticed something on his teeth he had brass. this boy hadn't been to the dentist once in his life. he had teeth all over the place the deceased he had ruined his teeth. this child had mental harpdz most of his life and will need

to overcome heel at least have straight healthy teeth. his new home gave them love and health. whether it's a safe stable home free from network or cold on the streets where you live is important and that home is where it all starts. i now have the honor of trood introducing our that panel. it's component of some of the leading experts in the nation. and all will be ablely managed by san francisco's own. our mod rate was brought in as the recreational administer. shows a recognized expert having

served 24 years on the housing authority. she certified on the bipartisan of the commission and was a leader of a number of housing organizations. ophelia has been recognized as one of the most influential hispanics and they was named the 2009 ultimate hispanic chef and one of the most influential hispanic with her 1345r9 leadership award. thank you. again ophelia for moderating >> our president under her leadership she used this for a plasma to improve the lives of people and build healthy

community. she is a authority on housing and it's relationship to health. she's leading this program and creating goals natural nationally human resources dr. josh he's known to many of you he serves homeless patient from the health clinic in this building. he is with the 4b9 and records all medical and health issues at the health programs. he's the society professor and family community in san francisco with his 22 years of serving homeless people he is an authority between home and health and finally, mag began. shows an investigator with

health watch they work to bring evidence and analysis from the front line of pediatric care she's the former director of the homeless program and is annotately recognized expert. shows published the dock for kids report how children are effected in health we're excited to have brought them together and look forward to hearing from them we're video taping all you have and them and we're going to put this on youtube. it's my honor for me to introduce her >> as i was watching this on

housing and health and had an opportunity to here mag an and one of the things you said was affordable housing is co-op children healthy. i wonder before each of you get into our remarks tell us one thing that stood out that has underscored and we'll let you all talk about that >> thank you very much i'm pleased to be here today. i think that i first coincide this phrase because i was trying to talk about why housing matters so much. i think in being a dr. i want to use a medical terminology but how being health maybe connected but those are height anyone else's helped.

if you can - we understand when we get a flu shot it's going to protect us for the rest of the season and helps us to protect our community. we vaccine children so when we vaccine children they have less flew in the elderly. so one of the things we know st. if you are in a family you're having a hard time affording informed if you're in on a affordable housing and you're not having the strain of debt your less likely to have stunned growth. and this when you think about connecting those things i think that's where i want to be able to talk to 9 public we support

vaccination programs because i want the homes to be healthy >> thanks for being here. >> thanks this is also my office as an opportunity to speak with you. it's interesting when people get sick that's when i get the opportunity to serve them. many of the people i serve live with trauma all their lives like illnesses from substance because when they get ill they end up occupy the street. i see someone across from me in my office i want them to be better. i have a prescription pad for medication. but i found the most effective to be comfortably their health

and give them the district is a beautiful permanent housing like here. so when you get a chance to see them move in i've had the great principle of handing someone a key and say welcome home. that's such a satisfying stunt as a physician and a person who lives and works in this beautiful city. >> next. >> i was very struck by dave appoint story about the young man in foster care. one of the statistics is that 40 percent of children engage in child welfare system ended up being homeless. that's powerful. so we looked at that statistic and did a pilot in new york and

can we reunite the family and go one step further can we demonstrate that affordable housing truly helps other outcomes like education any public comment? a small pilot 20ur7bd to be successful and is now being scaled across the country by federal government. to me this really demonstrates the power that a house has for improving the lives of people children and families. >> so meg began we'll take the time to let you door-to-door our work. >> it's interesting i got interested how health was effected. i was straight out of medicine school and i admitted a child to the icu with asthma i was struck

because she had pretty well controlled ass mass why is she here in the icu it was clear that one of the changes in the house was they got a cat. why would you get a cat address in this case, i knew she was geography to cats he actually found a mouse in her bed so they have this choice they knew the choice was all i could think about no amount of medicine was going to make it safe to send the kid back to the assignment that the pripths was a healthy home. i started thinking more and more about housing is a vital something like that.

when you going go to the doctor they take our temperature and height and weight and why do we look at the violate signed as the practice it's essential for our understanding of house. and housing should be a vital sign. we know there are signs we've tested like overcrowding and how frequently our moving. if you're moving two or more times in a year you're going to have bad health because when you think about that i more and more think about simple ways to integrate into health care our understanding of howard's and that idea of a stable decent home deemed the vaccine we need to deliver we need to think

about mori want to make sure more and more that health care is part find that conversation. so health care needs to be part of that conversation pvsh >> so i had this exciting moment when i was watching the daily show jon stewart and he had a guest and he said you, you know, john it's cheaper to house a homeless he popcorn than that to a leave them on the street and he got it; right? >> but that's just the beginning; right? we've begun that work to prove in some places it's less expensive to be insider. so at the placing down street we moved the one hundred plus

homeless adults into housing and we found their health care costs dropped dramatically and the cost of the building was over $1 million we saved the government that much. we know that housing is good it's remarkable it's less expensive and it reduces mortality. so people who are homeless at the time of their age diagnose in san francisco there are are about 6 hundred and 806 hundred and 10 hadn't moved into our housing but the 6 hundred and 10 people remarkably 75 percent of them were dead in 5 beyond a reasonable doubt. now for us who have been around

since 1979 i went to the unit for aids not because that was a place for mortality but a place for love was there. the likelihood someone would die in 2002 is the same as a homeless person in san francisco today, if they don't have a home. we found 71 other people that moved into the housing diode in two years. so the golden gate bridge we're demanding the medication why aren't we demanding housing. medication is insufficient to change the mortality code among sick folks it doesn't help without housing.

yet the dances for people most vulnerable is not there. and my hope is with the footage care act we'll have an opportunity pause the government is the affordable care act is hard to get enthusiastic about it but the system pays people to be sick. the most valuable person in our society is someone who builds mounds of health care some search warrant somewhat and someone with one leg who spend time in the hospital it incredibly good for the health care system now we're moving toward a health care that's hearth related.

if we've got to take the moment in history when we haven't figured out how to change our health care system to roll move the ball forward. i call you all not to sit aside and worry about the health care act but to 13wr5g9 housing. not all housing is the same. so here in san francisco we have 39 buildings. the buildings that are more beautiful have a great impact on health care outcomes. so for example, we have a social worker here he worked in a building that has a 2 percent mortality rate. we have it in union square west the tenderloin this has a reduction in mortality but if

you look at another facility they have 8 to pen e 10 percent mortality. what's the difference when we move a person from one location to another they don't die. we move them into about how far housing but they dead at a much higher rate. why should beauty and a healthy community make a difference in survive. many people with cancer at 129 mason don't today and others do. when i climb a mountain i feel the sense of well-being in higher soul that's what makes live worth living. we can do housing and that's great but when we try to do this

right and find the right treatment we need to honor that self-ethelcy and a bout makes a difference this is our chance and we can't let this fall away without grabbing it to make a difference >> so first, i want to thank home matters for hosting this conversation. this is a role important conversation that's not being had enough around the country. when he think about integrating of housing and health care josh and megan talked about the tremendous overwhelming outcome when you correct housing with health care but around the country those two systems howard and health care don't play nicely because they department obey trod to each other. the fact we have housing and health care represented here today and having this

conversation is important. i'm not surprised we're sitting in san francisco, california having this conversation. i think about the research in the - most people start the conversation with the research that was done in new york in the 70s looking at the exports of supportive housing in reducing the crisis system liked jails and hospitals and emergency rooms but if you look at the work that's done in california and i'd go remiss if i didn't mention harold in helping us think about the interaction of housing and health care and some of the work that's been done around this tenderloin district really providing direct access

in support off housing and that's really the model that we the rest of us in the country h have been learning from. if you look at the work that's being done around the country liquor in san francisco and chicago and massachusetts and maine main. would you indeed reduce our utilization of other programs. massachusetts is a great example they quantifyed the individual that go into housing we actually saw a close to $6,500 reduction in medicaid costs. and most of the other studies we've seen rouksz in costs but we didn't see this real

continual interaction of housing and health care pr we saw the health care providers getting into the housing and wait we didn't see the person go into the hospital but we didn't see community say health care you have 80 come to the table and housing you have to come to the table and let's work together and see the results. i'm proud to say that to san francisco is one of our projects we're looking at that what would happen if we targeted 14 of those around the country there's got to be an intellectual connection between housing and health care. so we have 4 community the state of connecticut and washington here in san francisco and also

los angeles. you'll be surprised to know we're learning different things in connecticut for over the years i've created a strong housing sfro infrastructure they're looking to see how they can partner with the homicides and the federally qualified health centers and the priority for them is the role of the patient navigator and they interface with the folks and interesting what they've seen is yeah. by having that patient navigator who can actively help navigate of the health system we're seeing better health care outcomes. we we didn't expect we're seeing resident respond very favorably to the role of the national

garter in helping combat stigma and it's been profile. powerful. in michigan in washing no way county it works well, there's one health care proifrd and one hospital and u.s. you can imagination the integration is not as champing. i note that one of the challenges we see it the access could integrated data getting data from all the parties especially the medicaid data. the gas station and collaboration is working well, in michigan. in los angeles they've created a transitional pool that's actually being used in the hospital by case irks when there's a homeless person identified the transitional is

used to access whether or not this is an individual who needs to go into supportive housing because of their chronic health issues what would be the best situation for them. in san francisco it's a captains of how do you link retinas with supportive housing to existing health care. and here this models very different from what we've supported of after the country with on site housing and on site health care. really the fact you've got those right next demeanor to each other we're seeing great outcomes as well. >> so we have about 20 years or more of research showing? effective and it makes me sort of think of homeless programs

over time. you might remember all the money went into shelters and then the idea of getting people into permanent housing and or even, you know, rocket scientists stop people from becoming homeless at the start. so what's the problem here is it not enough research or do we need more studies you know why is this we need and not seeing and josh if you would would you talk about the savings with going to the wrong pocket and a well, thank you that's a great question. i had the privilege of working with the president agency around homelessness last year and we found 5 community that were on took to end homelessness for

vendors they are a difference group in washington and alabama and indianapolis. so one of the things we did with the history of homelessness we've had well meaning people who went on hungry abstracts demanding people to get into a home. so we created those emergency housing programs and it shift and their realizing this health care treatment called permanent support of housing has to be targeted toward people who can't leave homelessness without treatment. this isn't true in san francisco but in other cities 90 percent of homeless people leave without the support. so the key is to find people

with medical problems who can only loaf with this robust treatment called ooshl homeless and about how far people who are most impaired they're able to move the aspire population towards ending homelessness. that's a critical next step. beyond the scope we need more research to answer our question but we have to not do what the va has done they don't want to leave anyone on the battle fold. so if some time someone comes to you and takes the treatment called housing what happened a week ago what happened to make them holmes homeless and sighing how can we help them. that's where our health care and

homeless programs help. >> it's interesting the first surgeon general a e mr. richmond developed a program so picture a cycle or circle s that has 3 equally dwbtd pieces and knowledge is only 1/3rd of the pie then there's strategic and political will be so 15 years ago when i got interested i think it was a question why don't home matter we know it matters we know what works and how to make people healthy and do supportive permanent housing. it's taking that piece of the pie we've got the